title: Prevalence of cryoglobulinemia and autoimmune markers in liver transplant patients.
abstract: OBJECTIVE
  To examine the prevalence of cryoglobulinemia and autoimmune markers in stable liver transplant recipients and to determine risk factors and clinical impact.
  
  
  METHODS
  Ninety-two liver transplant recipients were tested for cryoglobulinemia, hepatitis B and C, complement C3, complement C4, CH50, antinuclear antibodies, anticytoplasmic neutrophil antibodies, anticardiolipid antibodies, rheumatoid factors, and lymphocyte subpopulations. Liver, renal, and hematology tests were done. Immunosuppressive regimens were based on calcineurin inhibitors in 94.6% of the patients.
  
  
  RESULTS
  Cryoglobulinemia was present in 18 patients (19.5%) with characteristics of type II in 27.7%, type III in 61.3%, and indeterminate in 11%. Cryoglobulinemia was present in 55.5% of patients with positive hepatitis C virus serology compared with 35.86% of patients with negative hepatitis C virus serology (P = .06). Among those with hepatitis C virus markers, cryoglobulinemia was present in 30%. Anticytoplasmic neutrophil antibodies were positive in 23% of the patients with cryoglobulinemia, but in only 5.4% of the patients without cryoglobulinemia (P = .006). Albuminemia was significantly lower in patients with cryoglobulinemia (38 -/+ 4.2 g/L) than it was in patients without cryoglobulinemia (40.2 -/+ 3.4; P = .05). Cryoglobulinemia was symptomatic in 4 patients (22.2% of all patients). Independent factors associated with cryoglobulinemia were presence of anticytoplasmic neutrophil antibodies, more than 4 HLA incompatibilities, alanine aminotransferase level of 0.68 microkat/L or more, and an albuminemia level greater than 38 g/L.
  
  
  CONCLUSIONS
  Cryoglobulinemia is frequent after liver transplant and is symptomatic in approximately 20% of all patients.
authors.affiliation: Nephrology, Dialysis, and Multiorgan Transplant Unit, University Hospital, CHU Rangueil, Toulouse, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Garrouste
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.forename: Anne
authors.initials: A
authors.lastname: Boulestin
authors.forename: Laure
authors.initials: L
authors.lastname: Esposito
authors.forename: Laurence
authors.initials: L
authors.lastname: Lavayssiere
authors.forename: Dominique
authors.initials: D
authors.lastname: Durand
authors.forename: Antoine
authors.initials: A
authors.lastname: Blancher
authors.forename: Lionel
authors.initials: L
authors.lastname: Rostaing
mesh_terms: D000328:Adult; D000368:Aged; D015551:Autoimmunity / Q000276:immunology*; D003404:Creatinine / Q000378:metabolism; D003449:Cryoglobulinemia / Q000145:classification / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation / Q000009:adverse effects* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology* / Q000276:immunology*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D003404:Creatinine